CT scan results - verbatim

For those of you that have not had the opportunity to undergo a CT scan, it is not the most unpleasant diagnostic examination that you can experience. CT is the abbreviation for "Computed axial Tomography," which is sometimes referred to as "CAT," and it is basically an x-ray machine that spins around your body continuously recording digital data about your insides. It takes about five minutes, once you have ingested two quarts' worth of barium sulfate milkshakes over an hour (I chose the vanilla over the berry flavor) and are injected with an additional IV contrast agent (iodine-based, clear solution) during the scan itself. My PowerPort was accessed for this IV, making the whole process pretty straightforward. The oral contrast (barium sulfate) makes it easier to identify the stomach and intestines, and the IV contrast (iodine) makes it easier to "see" my blood vessels and heart. Both contrast agents are eliminated by my liver and kidneys. By the way, the IV contrast agent makes you feel warm inside (one CT technician warned me that it might make me feel like I'd wet my pants - but my experience was more of a warm, metallic tongue first and then a very slightly sweaty sensation spreading down my body and then up into my head). Then the table that I was laying on slides into a circular tunnel (not claustrophobic at all), the scanner starts to slowly spin around me, and a feminine machine voice says, "Breathe in and hold your breath." The table slowly slides out of the machine, and the voice says, "Breathe." It's good to be reminded to breathe every so often. And now we're all done.

Except for the waiting.

Since I am meeting with my oncologist on Wednesday next week and need to take the imagery/results with me, I asked the CT technician when the scan results would be available. He said that I could pick up the digital imagery immediately (since it is digital and all!), but that the radiologist would not look at the images until later that day. So I picked up the imagery and final report the next afternoon, and here is what it says [comments in square brackets are mine]:

HISTORY: Followup colon cancer in a 46-year-old male. He was initially diagnosed in March 2007. He underwent surgical resection in June 2007 [actually, the surgery was in April 2007, and chemo began in June]. Since that time, he has been treated with chemotherapy.

PROCEDURE: Following administration of oral and IV contrast, axial 5mm images were obtained from the lung apices [plural of apex - the top of the lungs] through the symphysis pubis [just below the bladder, basically].

FINDINGS: The lungs remain clear. No developing mass or nodule seen in either lung. No local infiltrate is present bilaterally [I believe that this is a redundant sentence, given the one immediately preceding it, but it might mean that the radiologist did not see any symmetrical "features" that should not be there]. No pleural effusion [excess fluid in the space around the lungs] is present bilaterally and no pericardial effusion [fluid around the heart] is seen. No areas of pleural thickening [increase in the width of the pleura - the lining of the sac that surrounds the lungs] are identified. No developing adenopathy [large/swollen lymph nodes] is seen within the chest. Heart size is normal [whew!].

The liver is normal in size. Numerous small low density nodules are again seen throughout the liver, which measure up to a maximum of about 11mm. All of these nodules were seen on the prior study from 5/22/2007 and appear stable in size and number. No enlarging or new mass is seen within the liver. The gallbladder, bile ducts, and pancreas appear normal. The spleen is normal in size. A tiny low density nodule [this usually means "fluid-filled" and is not cancerous] is seen on image 51, measuring about 6mm. This was present on the study from 5/22/2007 and has diminished in size. Adrenal glands and kidneys appear normal.

Postsurgical changes are present within the pelvis. A suture line is noted at the rectosigmoid junction [where the rectum connects with the large intestine] compatible with partial colonic resection [the surgery I had]. The remaining colon appears unremarkable [my new favorite diagnostic word!]. No areas of bowel wall thickening are seen. Small bowel appears unremarkable. No dilated bowel loops are present. No developing adenopathy is seen within the abdomen or pelvis. No ascites [accumulation of fluid in the peritoneal cavity - basically the area below your lungs and above your crotch] is present. Bladder appears unremarkable.

IMPRESSION:
1. No evidence for developing metastatic disease or recurrent neoplastic disease within the chest, abdomen, and pelvis.
2. Clear lungs.
3. Stable appearance and number of multiple small low density nodules in the liver. A prior ultrasound was performed on 3/29/2007, showing these to represent cysts. No new or enlarging mass is seen within the liver.
4. No developing adenopathy is seen within the chest, abdomen, and pelvis.
5. Postsurgical changes related to partial distal [toward the end] colon resection. Area of anastomosis [the site of the surgical reconnection of the two parts of my colon] appears unremarkable, without developing wall thickening. No adenopathy is seen within this region.
6. No ascites is present.
7. Tiny nonspecific low density nodule is seen at the anterior margin of the spleen, diminished in size when compared with the study on 5/22/2007.

So, with the caveat that I have not spoken to my oncologist yet, I think this CT scan result bespeaks quite good news. Thanks for your interest and attention, and you will now be returned to your regularly scheduled programming....